FORM 1023-EZ for A FRESH START ANIMAL RESCUE

Field Data
EIN 83-2102880
Case Number EO-2018281-000018
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A FRESH START ANIMAL RESCUE
Organization’s Mailing Address 110 IVY DARLENE
City NEW MARKET
State AL
ZIP 35761
Accounting period End 12
Primary contact name MYRA COUNTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MYRA COUNTS
PRESIDENT
110 IVY DARLENE
FAYETTEVILLE TN 37334

Officer/Director/Trustee Two

NATASHA BOWELS
TREASURER
49 GWATHNEY CHURCH RD
FAYETTEVILLE TN 37334

Officer/Director/Trustee Three

JENNIFER BUNN
VICE PRESIDENT
412 MAPLE ST W
FAYETTEVILLE TN 37334

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/14/18
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MYRA COUNTS
Signature Title PRESIDENT
Signature Date 10/3/18

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